Colectomy

There a number of reasons a colectomy may be the right medical decision for you. When the time is right, our team will be there to help you with your decision. We'll partner with you as you get back to living your fullest life.

Reasons for a colectomy

There are many reasons why your doctor would need to do a colectomy, or surgery to remove a segment or all your colon or large intestine. The most common reasons are:

A blockage (also called an obstruction) or a twisting (called a Volvulus) in the colon

Colon cancer, or other tumors within or involving the colon

Complicated diverticulitis or other cause of severe infection of the colon

Digestive tract disorders, such as Crohn's Disease or Ulcerative Colitis

Injury to the colon

Preparation for a colectomy

In most cases you will need to do a Colon Preparation. This process involves you using a very strong laxative to clean out all the stool from your colon. Cleaning out your colon helps to decrease your risk of infection after surgery.

Your doctor will give you specific instructions on the Colon Preparation. You will also get instructions on taking or stopping your regular medications.

During a colectomy surgery

Your colectomy surgery takes places while you are under general anesthesia, completely asleep. You will have a breathing tube placed in your airway.

Your doctor will discuss surgery options and what ones are best for you and your condition. There are 2 different ways your doctor can do a colectomy:

During your laparoscopic surgery your doctor will make a few small abdominal incisions. Then he or she will insert long, thin tools through the incisions and into your belly. One of the tools has a camera (called a “laparoscope”) on the end. This sends pictures to a TV screen. Your doctor can look at the screen to know where to cut and what to remove. Then he or she uses the long tools to do the surgery through the small cuts. Usually the surgeon will still need to make a medium size incision in your abdomen. This incision allows enough space to remove the piece of diseased colon and reconnect the 2 ends. The incision is still smaller than a traditional open surgery. You should have a quicker recovery.

During open surgery, the surgeon will make an incision in the middle of your abdomen. The surgeon will pull the colon off the inside of the abdominal wall. He or she will then use a surgical device to close off and cut through the colon. This will allow your doctor to remove the diseased part of your colon. In some cases your doctor may need to remove the entire colon, and may also need to remove your rectum. In the case of rectal cancer, he or she may remvoe both your rectum and anus. How much of your colon your doctor removes depends on the reason for your surgery. It also depends on how severe your condition is as well as the location of the disease within the colon or rectum.

We believe you should be a partner in your care. So we discuss these options with you before the surgery. But in some circumstances, the decison has to be made during your surgery. This depends on many circumstances:

The location of the disease in your colon or rectum

Ativity of infection or inflammation around your colon

How much of the colon needs removal

Reconnecting your colon or rectum

If your doctor is able to reconnect your colon or rectum, you should be able to have normal bowel movements. wOften we use a surgical device to connect the 2 ends and re-create the continuous tube in your colon.

A colostomy or an ileostomy

During this procedure your doctor will make a small hole on one side of your abdomen. Then he or she will bring the open end of your intestine through this opening in the skin. He or she sews the end of the intestine to the skin, holding it in place. The next step is to place a bag over this opening. Your bowel movements will come out through the hole into the bag attached to your skin.

If your doctor connects your large intestine to the hole, it’s called a colostomy. If your doctor connects your small intestine to the hole, it’s called an ileostomy.

Risks include but are not limited to:

Anastamotic leak or leaking of stool contents at the seam between the 2 ends of your colon. This can cause an abdominal infection requiring further surgery or other procedures.

Bleeding

Blockage in the intestines, called a bowel obstruction

Infection

Injury to surrounding organs, like other parts of the intestines, liver, spleen, kidney, ureters or the bladder

Recovery after colectomy

Most patients stay in the hospital for 3-7 days or more depending on your individual recovery. Your intestines need to heal before you can eat solid foods again. While healing, your doctor might give you nutrition through a vein in your arm. Most people can drink liquids within 1 to 2 days after surgery and eat solid foods soon after that. Before being discharged to go home, your surgeon will make sure that your intestines are working as expected and that you can tolerate regular food. You may need to be on a low-fiber diet for several weeks after colon surgery, while your colon is healing.

Most people will be out of work for 2-4 weeks following any major abdominal surgery. Most people will be about 80% recovered at 8 weeks, but complete healing will take 6-12 months.

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